How Healing Works

by Wayne Jonas

  “Jake, would you be interested in trying something that might help all that prayer you are having?” I had decided to explore working with Jake’s deep faith rather than provide long explanations about mind-body effect, placebo research, the immune system, and visualization.

  “Sure, Doc,” he responded quickly. “I always want…to help the Lord…in his will…I’m sure he…wants me healed…I’ll help…if I can.”

  I presented Jake with my proposal. “Is there any place in your lungs that you feel is clear? Any place you feel the air goes when you breathe in?” I asked.

  Jake thought for a while as I held my breath. Perhaps there was no opportunity to try my idea after all. He took a couple of breaths, deeper than the usual labored ones, and concentrated. Finally, he said, “Sure, Doc…air goes right here.” He pointed to a place on his lower left chest. “When I take…a breath…it all…goes right there.” He pointed again to the same place. An opening.

  “Great,” I said, seeing a window of hope. “Then here is what I want you to do. As you lie here and pray, I want you to try and relax as much as you can and then imagine in your mind that the air is going into that place and that place is expanding—getting bigger. Imagine that area gradually growing, getting larger and larger, clearer and clearer. Imagine all the love of the Lord and all of those prayers from your family and church and all the air coming into your lungs and clearing away the pneumonia you have—healing your lungs.”

  We did a few practices sessions in which I encouraged him to visit in his mind a place in his church that he loved, and to feel a sense of peace there. And then to imagine the love and power of the Lord was flowing into that small space in his lung. He got it quickly. Then he smiled. “That be easy, Doc…that be real easy…to do.”

  The next morning, I arrived at the hospital to visit Jake, fully expecting him to be on the ventilator. The ICU specialist watching him had thought he would not last the night on his own. Most people tire out and decompensate during the night, and Jake had been on the edge of that the day before. But to my surprise, when I walked into his room, he was sitting up in a chair and still just on the oxygen mask. During the night his oxygen levels had held steady. He smiled when he saw me come in.

  “How is it going, Jake?” I asked.

  He smiled again. “It goin’ fine, Doc….Goin’ fine….That thing…that thing you taught me…works real well. The place for air…gettin’ bigger.” He placed his hand over the left lower chest as he had done before but now using his whole hand to show a larger area. “Got no tube…last night.” He grinned.

  In fact, Jake never got intubated again. The next day his oxygen levels continued to improve, and within a week his pneumonia cleared sufficiently that he was discharged. Jake had healed himself—by using his mind and faith.

  THE BODY’S MIND

  Coincidence? I wondered. Yes, possibly. Much of healing is coincidence—something statisticians call “regression to the mean.” If you go in to see a doctor when you are sickest, what usually happens—no matter what you do—is improve. Doctors mistakenly attribute this improvement to the treatments they prescribe. So do patients. But in this case it didn’t seem like regression to the mean was an adequate explanation. Jake had had pneumonia before and recovered, so we knew he could. But he was not yet at the peak of this illness when he turned around. He had never recovered in this short a time—and without intubation.

  I didn’t know for sure if Jake had really healed himself with his mind and faith. Most patients don’t care whether the healing they experience is called “regression to the mean” or a miracle—they are just happy to be better. However, I did know there was rigorous research showing that our mind can influence healing for a number of conditions including pain, anxiety and depression, Parkinson’s and Alzheimer’s disease, high blood pressure, and heart disease. And it can alter immune function—as it appeared to do in Jake’s situation. Professor Alia Crum of Stanford, whose research on “Mind over Milkshakes” I described in chapter 6 (see this page), has demonstrated how our mind-set, which she defines as our “conscious and embodied expectation to heal,” infuses all treatments including those involving drugs, food, exercise, and stress. How we individually and culturally think of and frame a treatment is often the largest contributor to whether and how much that treatment works. Mind-set can also influence the amount of pain and rate of recovery from surgery.

  I was in high school when President Nixon visited China in 1972, and the reporter James Reston, who accompanied him, described the amazing power of acupuncture to treat pain, including his own after an emergency operation he underwent there. He described doctors doing full-blown open heart surgery on patients without anesthesia—under the palliative influence of acupuncture alone. I saw similar cases of surgery done without anesthesia using hypnosis during my rotations in psychiatry in the United States. We know the role of the mind in healing is huge, but how it operates is still largely a mystery. At the time I met Jake, studies were just emerging exploring the influence of visualization on biology. Most of these studies involve creating specific images in the mind under relaxed conditions, seeking to influence biological processes. We now know that visualization can influence a number of conditions. This includes reduction of pain, bleeding, and infection after surgery, and acceleration of recovery time. Chronic conditions also benefit from visualization, including high blood pressure, chronic pain, depression, and PTSD. Professional athletes routinely use visualization to enhance endurance and performance. Golf and other skill-based games improve through mental practice.

  In 2015, Dr. Mimi Guarneri and Rauni King from Scripps Hospital, along with a colleague, Dr. Shamini Jain from Samueli Institute, conducted a study at Camp Pendleton, California, testing whether mental relaxation in the presence of another combined with mental imagery could help Marines with PTSD. All the Marines in the study had been deployed to Iraq or Afghanistan and suffered significant PTSD on their return. All had received standard treatment with medication and counseling. In the study, half of the Marines were given continued standard treatment and half were given a visualization tape to listen to, along with four treatments of a relaxation method called “healing touch,” an approach taught to nurses in which they hold their hands over the patient—similar to what I used with Susan during her chemotherapy. After each of the four deep relaxation sessions, the Marines were asked to listen to a visualization CD once a day for twenty minutes. The CD took them to a safe place of their choosing where the relaxation response was reinforced daily. After three weeks, the Marines were tested again for PTSD. There was more than a 25% drop in PTSD scores in those who used the relaxation sessions and visualization tape compared to usual treatment—an improvement as great as any current PTSD treatment we have with medications or psychotherapy. After the relaxation sessions and visualization practice, the average PTSD scores for the group went below what was considered abnormal. The usual care group improved slightly but was still above the cutoff for PTSD.

  JOE

  What I found most remarkable about this, however, were the stories service members told about the “coincidental” effects visualization had on them. Joe, a thick-skinned Marine who had been deployed four times, recounted how a buddy, killed next to him in a battle, appeared to him during one of his visualization exercises. The appearance was more than an image, he said. His buddy reached out and touched him—“I felt it,” said Joe. His buddy then said that he was fine and that he would always love Joe and be watching over him. “Go on with your life,” the phantom buddy said, “you have lots of life left to live, and we did good together.”

  Joe did not tell his physician about this episode, but broke down in tears at his next healing touch session with the nurse. “Now I know everything will be okay,” he said to her after the session. Later, Joe’s wife noticed how much less agitated he was. Joe had what is called an “exceptional spiritual experience,” meaning one that goes beyond the normal experiences of everyday consciousness. Peop
le who have such experiences often describe them as profound, overwhelming, indescribable, and even frightening. They are more than just images—they look, sound, and feel completely real. And the body reacts to them as if they were real. As it turns out, lots of people have these experiences—especially when faced with a life-threatening situation and when they cultivate an open, relaxed mind. They frequently occur during the night and wake people from sleep.

  Dr. David Hufford, emeritus professor of sociology and medicine at Penn State University, is one of the world’s experts on these exceptional experiences. He told me that between 30% and 40% of people around the world have them at some point in their lives, regardless of the culture they live in. Traumatic experiences increase the likelihood of these experiences. In a study Dr. Hufford did of veterans who returned from the wars in Iraq and Afghanistan, he found that more than 60% of those exposed to combat had these experiences.

  “That is a very high rate,” he said, “almost double the baseline rate in our culture.” These experiences are so profound and sometimes frightening that soldiers rarely talk about them. They are afraid of being labeled “crazy” and put into mental health treatment. Dr. Hufford explained, “If these exceptional experiences are labeled negatively—called hallucinations or a mental illness—that can be damaging. If they are acknowledged as real and treated positively, they can be profoundly healing. Many cultures will use these experiences to help heal a person. Modern medicine usually thinks of them as a sign of illness. We need to reframe how health care deals with these experiences.”

  In Dr. Guarneri’s study, she did not ask how often these experiences occurred in the Marines who did the visualization and healing touch relaxation, so we don’t know how common experiences like Joe’s were in that group. We do know that hostility scores in the group—something very difficult to improve in war-induced PTSD—dropped markedly in those who did the visualization. They had found a tool and a process to tap into the healing power through their minds and spirits.

  BEYOND BELIEF

  Belief is a powerful tool for healing. But specific mental practices like those Jake and Joe used do not take optimal advantage of the unconscious processes of meaning-making that occur in the everyday rituals of health care delivery. Research on placebo effects, as described in previous chapters, demonstrates that potential. When ritual and belief are combined with repeated social ritual, they can produce profound effects on chronic illness including pain, mental health, and the immune system. At the time I saw Jake, Dr. Robert Ader, a pioneer in the investigation of conditioned learning and immune function, was demonstrating that by repeatedly pairing the use of an inert substance (a placebo) with an immune-suppressing drug, one could teach the immune system to respond to the inert substance even when the drug was withdrawn. He used rats that had a genetically inbred autoimmune condition—their own immune systems were killing their bodies prematurely, like what goes on in lupus or multiple sclerosis. When this autoimmunity was suppressed with a drug called cyclophosphamide, the rats lived longer. Dr. Ader used a simple process of classical conditioning to train the animals’ immune systems to lower their harmful activities. He did this by giving the cyclophosphamide along with a sugar solution. After several pairings of the drug and sugar solution, the drug was gradually reduced but the sugar solution was maintained. Animals who continued to get the sugar solution also continued to have a dampened immune system—and lived almost as long as if they had received the actual drug!

  Studies now show that the human immune system can also be taught to do this. Drink Kool-Aid and take an immune-modulating drug a few times together, and soon (within three or four sequences) you can withdraw the drug and get the immune modulation effect—nearly 80% of it—from the Kool-Aid alone. (Don’t try this at home! Immune-modulating drugs must be carefully monitored, and this conditioning approach requires precise timing and supervision.) But most people already use the benefit of mental conditioning without even knowing it. Take a headache pill with aspirin in it and you will feel better. Do this a few times, and soon just taking a pill (even without aspirin in it) eases the headache. Meaning influences effect.

  When people take an effective brand-name drug for a while, they get used to its working. If they switch to a generic or lower-cost version of the drug, they often report it does not work as well. And it truly won’t work as well, but not because the chemicals in the drug have stopped working. Studies have shown that, at least for pain and depression, if a person thinks she is getting a “discounted” drug, rather than the full-priced drug, she will report it as less effective. Another example is that when a “new, improved” drug comes along for an illness (based on hype and advertising), the older drug loses some of its effectiveness as people lose confidence in it. Professor Dan Moerman, the anthropologist from the University of Michigan introduced in chapter 2 (see this page), demonstrated this dramatically by tracking the effects of established drugs proven to work when a supposedly better drug came along. For example, when a new drug called ranitidine got FDA approval for treatment of stomach ulcers, the company marketed it extensively as better than an established drug called cimetidine. Cimetidine was working well—healing ulcers in about 75% of patients who took it and about 20% more than placebo. However, as excitement grew and use of ranitidine gained popularity, the healing rate of the older drug, cimetidine, diminished—dropping to below 50%. The magnitude of the older drug’s effects diminished as the collective mind-set was drawn to the new and “better” drug. So, remarkably, a treatment’s healing potency depends not only on how well it actually works, but also on a culture’s belief in the relative benefit of alternative treatments for those same conditions. No wonder pharmaceutical companies spend billions pushing new drugs when they first get approved. Not only do the sales go up because of the marketing, but the actual effects are increased if the culture believes they are effective. They are building both conscious and unconscious belief. One of my medical school professors used to admonish his students to “use a new treatment as much as possible when it first comes out, before it loses its effectiveness.” Now I know why he said that. Our collective mind affects the magnitude of the meaning. The meaning affects the magnitude of healing.

  If this works with rats, how much more effective can it be with humans? Humans have such a powerful mind for making meaning that they can produce this same kind of conditioning with their own words and imagination—no Kool-Aid or pills required. Pediatrician Dr. Karen Olness of Northwest University reported an example of this in a child with an autoimmune disease similar to that of Dr. Ader’s rats. The child needed immune-suppressive medications for kidney disease, but they were making her so nauseous that she could not take them anymore. This increased the risk that her disease would flare and threaten her life. Dr. Olness first used a rose fragrance and paired it with the immune-suppressive drugs and nausea-suppressing medications to condition the child’s system to react less severely to the immune-suppressing medications. She also taught the child to imagine a rose during these treatments. Soon the side effects of giving the immune-suppressing drugs could be reduced while maintaining the drugs’ effectiveness—provided the child imagined the smell and look of a rose when she took them! The child had learned how to control her nausea and immune system with her mind. Like Jake, she used her newfound visualization skills to heal. Children are especially adept at learning to use their minds to heal. A simple visualization CD for children with irritable bowel and stomach pain is more effective and longer lasting than any medication. All the doctor needs to do is give the child the CD and support her in using it.

  DANCE OF MINDS

  UCLA professor of psychiatry and best-selling author Dr. Daniel Siegel writes about how modern science is revealing a picture of the mind very different from the traditional one currently held by medicine. Rather than think of the mind as emanating from the brain—inside the skull only—he describes the view emerging from whole systems science that the mind operates more as if it res
ides between individuals, the culture, and the environment. In his book Mind: A Journey to the Heart of Being Human, he explains: “Mind is not just what the brain does, not even the social brain. The mind may be something emerging from a higher level of systems functioning than simply what happens inside the skull. This system’s basic elements are energy and information flow—and that flow happens inside of us, and between ourselves and others and the world.” A growing number of scientists share this view, as more and more evidence accumulates to support it. I am struck by how consistent this view is with the model Dr. Manu drew for me on his whiteboard in rural India as he tried to explain the ancient Ayurveda view of a person. Rather than being separate from others, as our bodies are, the deeper dimensions of our being—in mind and spirit—show that we are all merged together into one inseparable and overlapping mind. Our mind is collective. If this way of understanding the mind is a more accurate description of what we are as humans, then tapping this power of the mind and spirit is essential in order to fully heal and be whole.

  Our collective-like mind’s influence on healing goes on every day in the clinical encounter. It does not always require long periods of visualization like Jake undertook or the healing touch relaxation given to Joe, the Marine. The meaning response—both good and bad—can come in an instant. The British physician K. B. Thomas demonstrated this in 1987 with a remarkable study entitled “Is there any point to being positive?” He studied two hundred patients who came to the doctor with no specific pathology, only symptoms of illness. This type of patient makes up about half of all visits to a primary care doctor. He divided the two hundred patients into four groups. Two groups got either a positive consultation, in which they were told they had a clear illness that would resolve soon, or a negative consultation, in which they were told that the doctor did not know what they had or if they would get better. Half of each group was then given a placebo pill and the other half nothing. All treatments took the same amount of time.